Heart Failure Management

Introduction

Heart failure (HF) is a chronic condition where the heart doesn’t pump blood as well as it should. This leads to fluid buildup, shortness of breath, and fatigue. Treatment focuses on improving symptoms, slowing progression, and reducing hospitalizations.

Causes of Heart Failure

  • Coronary artery disease (CAD) – Blocked arteries reduce blood supply to the heart.
  • Hypertension (high blood pressure) – Excess pressure forces the heart to work harder.
  • Cardiomyopathy – Damage to the heart muscle from infections, alcohol, or genetic defects.
  • Valvular disease – Malfunctioning heart valves impair blood flow.
  • Arrhythmias – Irregular heartbeats reduce efficiency.

Types of Heart Failure

  • Heart Failure with Reduced Ejection Fraction (HFrEF) – The heart’s contraction is weakened.
  • Heart Failure with Preserved Ejection Fraction (HFpEF) – The heart muscles are stiff, impacting filling.

Symptoms

  • Shortness of breath
  • Swelling in legs and ankles (edema)
  • Fatigue and weakness
  • Rapid or irregular heartbeat
  • Persistent cough with white or pink mucus
  • Sudden weight gain (fluid retention)

Treatment Approaches

1. Lifestyle Modifications

  • Diet: Reduce salt intake, manage fluid consumption, eat a balanced diet.
  • Exercise: Regular, moderate physical activity improves heart function.
  • Weight Management: Avoid obesity, monitor daily weight changes.

2. Medications

  • ACE Inhibitors or ARBs: Reduce blood pressure, improve heart function.
  • Beta-blockers: Slow heart rate, reduce strain.
  • Diuretics: Lower fluid buildup, reducing swelling.
  • Mineralocorticoid Receptor Antagonists (MRAs): Help regulate salt and water balance.
  • SGLT2 inhibitors: Newer class that improves heart and kidney function.
  • ARNis: Combine ARBs and neprilysin inhibitors to reduce heart strain.

3. Medical Devices and Surgery

  • Pacemakers & Defibrillators: Help regulate heart rhythm in advanced cases.
  • LVAD (Left Ventricular Assist Device): Mechanical pump for severe failure.
  • Heart transplant: The final option for those with end-stage disease.

Conclusion

With proper management, people can live fulfilling lives despite heart failure. Early detection, adherence to medication, and lifestyle changes are key to improved outcomes.

Source recommendations

1. American College of Cardiology/American Heart Association Heart Failure Guidelines

  1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063
  2. https://www.acc.org/Guidelines
  3. https://www.jacc.org/doi/10.1016/j.jacc.2023.12.024
  4. https://www.acc.org/education-and-meetings/products-and-resources/features/global-cv-institute/heart-failure-guidelines
  5. https://professional.heart.org/en/guidelines-and-statements

2. European Society of Cardiology Guidelines on Heart Failure

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-and-Chronic-Heart-Failure
  2. https://academic.oup.com/eurheartj/article/42/36/3599/6358045
  3. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Focused-Update-on-Heart-Failure-Guidelines
  4. https://academic.oup.com/eurheartj/article/44/37/3627/7246292
  5. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines

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